Hillsboro Medicaid providers reported $95,636 in billed services for the Procedures / Professional Services category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represents a 37.7% increase compared to the prior year, when $69,432 in claims were filed for the same service type.
Medicaid is a government-run health insurance program administered by states and funded by both federal and state governments. The program serves low-income individuals and families, seniors, children, and people with disabilities, making it one of the key pillars of health care coverage in the United States.
Because taxpayer dollars fund Medicaid payments, fluctuations in local billing affect how health care resources are distributed within the community.
The Procedures / Professional Services category includes Medicaid-billed services designated by care type, defined by standardized HCPCS and CPT code groups. For this review, individual billing codes were placed within a single service category based on their code prefixes and numerical groupings—helping categorize related services, prevent double-counting, and maintain consistent rankings over time.
In Hillsboro, even with spending up across several categories, Procedures / Professional Services was ranked seventh for total Medicaid payments in 2024.
This category secured the fifth spot statewide for total Medicaid payments in Ohio for the year.
Across the five years leading up to 2024, Medicaid payments for Procedures / Professional Services in Hillsboro rose by $59,811, or 166.9%. This increase accelerated at specific times, as larger year-over-year jumps occurred in 2023 and 2021.
Though Medicaid spending for this category was distributed citywide, it was highly concentrated among a small number of ZIP codes. In 2024, ZIP code 45133 accounted for all $95,636 paid out for Procedures / Professional Services in Hillsboro, representing 100% of such Medicaid payments citywide during the year.
Payments were also focused on a select group of specific billing codes within the Procedures / Professional Services category.
Comparatively, Medicaid spending on Procedures / Professional Services in Hillsboro rose 37.7% between 2024 and 2023, while aggregate Medicaid payments citywide for all claim categories increased 33.6% during the same period.
The Centers for Medicare & Medicaid Services reported combined federal and state Medicaid spending at about $871.7 billion in fiscal year 2023. This accounted for about 18% of all national health expenditures, up sharply from about $613.5 billion in 2019 pre-COVID-19 pandemic.
This jump represents approximately 40% growth over just a few years, fueled mostly by increased enrollment and greater service use during and after the pandemic.
Federal budget measures passed during the Trump administration, including the “One Big Beautiful Bill Act,” signed in 2025, are expected to reduce federal Medicaid funding by more than $1 trillion over the coming decade. New provisions such as work requirements and higher cost-sharing are likely to limit coverage and federal funding for some participants, with states absorbing more of the expenses even as the program remains vital for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $35,825 | -3.4% |
| 2021 | $46,546 | 29.9% |
| 2022 | $51,758 | 11.2% |
| 2023 | $69,432 | 34.1% |
| 2024 | $95,636 | 37.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,711,845 | 35.1% |
| 2 | Medicine Services and Procedures | $1,406,033 | 28.9% |
| 3 | Radiology Procedures | $804,404 | 16.5% |
| 4 | Pathology and Laboratory Procedures | $357,212 | 7.3% |
| 5 | National Codes Established for State Medicaid Agencies | $218,977 | 4.5% |
| 6 | Surgery | $109,915 | 2.3% |
| 7 | Procedures / Professional Services | $95,636 | 2% |
| 8 | Durable Medical Equipment | $62,769 | 1.3% |
| 9 | Dental Services | $60,260 | 1.2% |
| 10 | Drugs Administered Other than Oral Method | $31,481 | 0.6% |
| 11 | Vision Services | $12,102 | 0.2% |
| 12 | Medical And Surgical Supplies | $1,479 | <0.1% |
| 13 | Outpatient PPS | $102 | <0.1% |
| 14 | Temporary Codes | $16 | <0.1% |
| 15 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 15 | Alcohol and Drug Abuse Treatment | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0378 | Hospital observation per hr | $68,491 | 11 |
| G0481 | Drug test def 8-14 classes | $20,726 | 9 |
| G0467 | Fqhc visit, estab pt | $4,329 | 10 |
| G0480 | Drug test def 1-7 classes | $2,066 | 3 |
| G0463 | Hospital outpt clinic visit | $22 | 1 |
| G8419 | Calc bmi out nrm param nof/u | $0 | 4 |
| G8427 | Docrev cur meds by elig clin | $0 | 5 |
| G8484 | Flu immunize no admin | $0 | 1 |
| G8510 | Scr dep neg, no plan reqd | $0 | 52 |
| G8783 | Bp scrn perf rec interval | $0 | 63 |
Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.
Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.